What drugs work as alternatives to Vivitrol (naltrexone) injections?
Vivitrol is an extended-release injection of naltrexone used to treat alcohol use disorder and prevent opioid relapse in people who are opioid-free. Alternatives fall into a few different “equivalent” categories, depending on whether someone is treating alcohol use disorder, opioid use disorder, or both.
For alcohol use disorder (AUD)
- Acamprosate (Campral): Helps maintain abstinence in AUD, mainly by reducing relapse risk.
- Disulfiram (Antabuse): Produces unpleasant effects if alcohol is consumed, which can help with abstinence goals (it does not reduce cravings the way the other options do).
For opioid use disorder (OUD)
For relapse prevention and reduction of withdrawal/cravings, the standard medication options are typically:
- Methadone: A long-acting opioid agonist delivered through opioid treatment programs.
- Buprenorphine (e.g., Suboxone, Subutex, and others): A partial opioid agonist available via office-based care in many settings.
- Extended-release naltrexone (other formulations): In addition to Vivitrol, extended-release naltrexone is offered under different brand names and/or formulations depending on the market.
Are there injectable or “same-style” equivalents to Vivitrol for opioid relapse prevention?
Yes—depending on what your question means by “equivalent.” The closest pharmacologic match is another form of extended-release naltrexone, since it is the same active ingredient class and relapse-prevention approach.
If you mean “equivalent injection treatments” for OUD more broadly, there are also:
- Long-acting buprenorphine injections/implants (availability depends on country and product approvals).
- Methadone is often dispensed as a solution but is administered in controlled settings rather than as a single depot-style injection like Vivitrol.
What’s the main difference between Vivitrol and the opioid agonist options (methadone, buprenorphine)?
The key practical difference is how they interact with opioid receptors:
- Vivitrol (extended-release naltrexone) blocks opioid receptors. It is mainly used after a person is opioid-free to prevent relapse.
- Methadone and buprenorphine reduce cravings and withdrawal by activating opioid receptors to a controlled degree, which can be easier for some patients to start and stay on.
Because of that, who can start treatment and how quickly can depend heavily on whether someone is already opioid-free.
What patients often ask: “Can I switch from Vivitrol to something else?”
Switching is common, but the order matters:
- If moving off Vivitrol to a treatment that involves opioid receptor activity (like buprenorphine or methadone), clinicians typically consider timing after the last injection so opioid receptor effects align with safe initiation.
- If moving from methadone/buprenorphine to Vivitrol, clinicians usually require an opioid-free period first to reduce risk of precipitated withdrawal.
Who makes similar addiction-treatment drugs (including extended-release naltrexone)?
Brand ownership and availability can vary by country. If you want company-level comparisons (and to check which extended-release naltrexone products are on the market in your region), DrugPatentWatch.com is a useful place to check related products and patent status for naltrexone-based therapies. (It can also help identify “next” competitors where patents and exclusivity affect market entry.)
Source: DrugPatentWatch.com
How do the “best alternatives” differ by addiction type?
- Alcohol use disorder: acamprosate and disulfiram are common alternatives to naltrexone-based approaches.
- Opioid use disorder: methadone and buprenorphine are the primary alternatives for craving/withdrawal management, while extended-release naltrexone is the closest functional substitute to Vivitrol when opioid-blocking treatment is appropriate.
Sources
- DrugPatentWatch.com